After the break-up of the Soviet Union in 1991, the countries that emerged from it faced myriad challenges, including the need to reorganize the organization, financing and provision of health services. Over two decades later, this book analyses the progress that twelve of these countries (Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, the Republic of Moldova, the Russian Federation, Tajikistan, Turkmenistan, Ukraine and Uzbekistan) have made in reforming their health systems.

Building on the health system reviews of the European Observatory on Health Systems and Policies (the HiT series), it illustrates the benefits of international comparisons of health systems, describing the often markedly different paths taken and evaluating the consequences of these choices.

This book will be an important resource for those with an interest in health systems and policies in the post-Soviet countries, but also for those interested in health systems in general. It will be of particular use to governments in central and eastern Europe and the former Soviet countries (and those advising them), to international and non-governmental organizations active in the region, and to researchers of health systems and policies.

Contents

• Foreword
• Acknowledgements
• List of abbreviations
• About the authors
• Chapter 1. Introduction
  Bernd Rechel, Erica Richardson, and Martin McKee.
  • Analysing post-Soviet health systems
  • Structure of the book
  • References
• Chapter 2. Health trends
  Bayard Roberts, Marina Karanikolos, and Bernd Rechel.
  • Introduction
  • Life expectancy and mortality
  • Morbidity
  • Key risk factors
  • Conclusion
  • References
• Chapter 3. Organization and governance
  Katharine Footman and Erica Richardson.
  • Introduction
  • Key actors
  • Decentralization and centralization
  • Regulation
  • Health information management
  • Population involvement
  • Conclusion
  • References
• Chapter 4. Health financing
  Erica Richardson.
  • Introduction
  • Expenditure
  • Sources of revenue
  • Coverage (breadth, scope and depth)
  • Statutory financing systems
  • Pooling of funds
  • Payment mechanisms
  • Out-of-pocket payments
  • External sources of funds
  • Parallel health systems
  • Voluntary health insurance
  • Conclusion
  • References
• Chapter 5. Health workforce
  Marina Karanikolos, Charlotte Kühlbrandt, and Erica Richardson.
  • Introduction
  • Health workforce trends
  • Professional mobility
  • Training
  • Doctors’ career paths
  • Conclusion
  • References
• Chapter 6. Public health
  Bernd Rechel.
  • Introduction
  • Historical background
  • Organization
  • Financing
  • Health protection
  • Disease prevention
  • Health promotion
  • Intersectoral action
  • Conclusion
  • References
• Chapter 7. Primary health care
  Charlotte Kühlbrandt.
  • Introduction
  • Historical background
  • Reform trajectories
  • Current settings and models of primary care
  • Provision of services
  • Access to primary care
  • Quality of primary care
  • Conclusions
  • References
• Chapter 8. Specialized and inpatient services
  Ketevan Glonti.
  • Introduction
  • Historical background
  • Infrastructure
  • Organization and provision
  • Rayon hospitals
  • Quality
  • Access
  • Conclusion
  • References
• Chapter 9. Pharmaceutical care
  Erica Richardson, Nina Sautenkova, and Ganna Bolokhovets.
  • Introduction
  • Pharmaceutical production
  • Regulation of pharmaceuticals
  • Pricing pharmaceuticals
  • Measures to improve cost–effectiveness
  • Access to pharmaceuticals
  • Conclusion
  • References
• Chapter 10. Mental health care
  Ionela Petrea and Milou Haggenburg.
  • Introduction
  • Historical background
  • Post-Soviet mental health policies
  • Organization and provision of mental health care
  • Human resources
  • Adequacy and quality of mental health services
  • Conclusion
  • References
• Chapter 11. Health system performance
  Bernd Rechel and Marina Karanikolos.
  • Introduction
  • Financial protection and equity in financing
  • User experience and equity of access
  • Health outcomes, health service outcomes and quality of care
  • Health system efficiency
  • Transparency and accountability
  • Conclusion
  • References
• Chapter 12. Conclusions
  Bernd Rechel, Erica Richardson, and Martin McKee.
  • Introduction
  • A persisting health gap
  • The need for better data
  • Reducing inequities
  • Improving access
  • Making better use of resources
  • Improving quality
  • Strengthening governance
  • Investing in health
  • References

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The European Observatory on Health Systems and Policies supports and promotes evidence-based health policy-making through comprehensive and rigorous analysis of health systems in Europe. It brings together a wide range of policy-makers, academics and practitioners to analyse trends in health reform, drawing on experience from across Europe to illuminate policy issues.

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